1. PAEDIATICS
BY. MS. ASABA MARION
Email ;mugonzebwamarie@gmail.com

2. • Assessment methodology
• Techniques employed
• (individual assignment, group write ups and group presentations -
20% of 1st assessment total marks )
• Final Exam 60%.

3. Objectives
• By the end of this lesson students should be able to;
1. Define the common terms uses in pediatrics
2. Define the normal newborn
3. List the xtics of the normal newborn
4. Briefly describe physiological changes of the newborn
5. etc

4. PEDIATRICS
RECAP
• Definition
• Pediatrics is a branch of medical science that entails the study of
health conditions regards to infants, children and adolescents and
their ability to achieve full potential as adults
• Pediatrics nursing or child health nursing is a specialty in nursing that
deals with the care of babies from the time of birth, infants, and
children through to adolescence. A nurse trained in this specialty is
called a pediatric Nurse.

5. • Terms used in pediatrics
• Neonatal
• Neonate is a baby from birth up to 28 days of life
• Perinatal
• Baby within the first week of life (7days)
• Infant
• Baby from birth up to one year
• .

6. • Toddler
• A child from one year to 3 years
• Perinatal mortality rate
• This refers to the total number of still-birth and neonatal death in the
first week of life per 1000total births

7. • Neonatal mortality rate
• The number of deaths under 28 days of age per 1000 live birth
• Infant mortality rate
• Number of infants’ death below one year per 1000 total birth
• Post-natal mortality rate
• The number of death over 28 days but under 0ne year of age per 1000 live
births
• Term baby
• Baby born from 37 completed weeks to less than 42 weeks of gestation or
<259to >293 of gestation

8. • Pre-term
• Baby born less than 37 weeks /< than 259 days of gestation
• Low birth weight.
• A birth weight of less than 2500g
• Very low birth weight
• A birth weight less than 1500g

9. • Post maturity
• Is a condition in which a pregnancy lasts longer than 42weeks of
gestation.
• Large for age
• A new born whether premature, full term or post mature who weighs
more than normal for the time spent in the uterus is considered large
for gestation age.
• Birth asphyxia
• Is failure to initiate and sustain breathing at birth.

10. NORMAL NEWBORN BABY
• Definition
• A baby is termed normal when it is born at term, weighs
approximately 3.5kgs when fully extended measures 50cms from the
crown of the head to the heels and has an occipital-frontal
circumference of 33-35cm. has strong husty cry, color pink and
respiration 30-60b/min.

11. • Neonatal period
• Is the period from birth to 4 weeks postnatal.
• After the initial observation for conditions requiring immediate
intervention, the neonate is sent to the nursery / neonatal care unit
for purpose of follow up and stablisation.

12. Roles of Neonatal Nurse
• To carry out interpersonal communication
• To take complete history of the mother and the neonate
• To be sure that the neonate has the identification band
• To make complete physical assessment ( general assessments,
appearance, V.S, Gestational age assessment)
• Prevention of hemorrhage ( administer vit. K if not given in the
delivery room)
• Documentation
• Etc.

13. Normal physical characteristics of a newborn
baby
• posture /Lie
• Baby lie in an attitude flection in
the supine position with his
head turned to one side and
shoulder elevated off the
mattress or in the prone position
with his buttocks elevated,
knees drawn up under his
abdomen and his head turned to
one side.

14. • Skin:
• The color is pink, vernix caseosa
and lanugo may be present. The
baby’s hands and feet may be
slightly blue immediately after
birth
• Vernix caseosa : a white stiky
substance is present on the baby’s
skin at birth . it is thought to have a
protective function and its mostly
absorbed within few hours.

17. • Cry:
• It should be normal husty cry
(strong and healthy).
• High pitched cry is in
neurological damage, infection,
hypothermia.
• Activity
• Normal infant moves limbs
freely and muscle tone is good

18. • Respiration
• The normal baby has a
respiration rate of 30-60breaths
per minute regular and begins
immediately after birth.
• .
• Weight
• The normal full term infant
weighs approximately 2.2-
3.5kgs
• Average 2.7kgs

19. • Respiration
•
• Respiratory movement is mainly
diaphragmatic. Therefore ,
inspiration indrawning of soft
lower ribs and intercostal spaces
can be seen even in healthy
babies

20. • Length
• From the highest point of vertex
of the head to the heel. It ranges
between 45-50cms. Average 50
cms
• Head
• The occipital frontal
circumference is 33-35cms
average 35cms
• Chest circumference 3cm

22. • Mouth
• Mucous membrane is pink and moist suckling reflex and swallowing
are good.
• False tooth some times may be present but disappear with time
• Tongue tie though rare
• Throat should also be examined for cleft lip and cleft palate and uvula
• The newborn has taste senses sensation and can differentiate sweet
from bitter and refuses non-agreeable substances

24. • Tongue tie

25. • False tooth

26. • Eyes
• They should be bright and clear.
They may be unco-ordinated and
appear slightly crossed for first
several days or weeks
• No tears are present in the eyes
• And become infected easily

27. • Ears
• The cartilage at birth is well
termed

28. • Nose
• The nostrils at birth may be
blocked due to accumulation of
mucus.
• When clear the baby breathes
freely through the nose and
possesses sense of smell

29. • Heart rate
• Normal heart rate of a new born 120-180b/m.
• Most of the murmurs head in the first week are not associated with
cardiac anomalies.
• Cardiac arrhythmias are normally found when the baby is in deep
sleep

30. • Body
• The chest is flat,
• Abdomen is relatively prominent
, xiphisternum is small nodular
and often mobile situated under
the skin at the distal end of the
sternum

31. • Umbilical cord
• Should contain 3 blood vessels
and no bleeding
• The umbilical stump is very
moist

32. • Endocrine system:
• Swollen breasts;
• Appears on 3rd day in both sex, & lasts for 2-3 weeks and gradually
disappears without treatment
• N.B the breasts should not be expresses as this may result in infection
or tissue damage

33. • Urinary system
• Normally, the newborn has the bladder and voids at birth or some
hours later.

34. • Genitals
• In girls born at term the labia
minora &clitoris are more
prominent.
• A milky white vaginal discharge
may be seen in the first week.
Sometimes its blood tingled
(witch’s menstruation) caused by
maternal hormones

35. • Genitals
• In boys testes are descended
into the scrotum which has
plentiful rugae
• The urethral meatus open at the
tip of the penis and the prepuce
is adhered to the glands

36. • The central nervous system:
• Reflexes
• Successful use of reflex mechanism is a strong evidence of normal
functioning CNS.

37. • Assignment 1
TAKE HOME
• 1: discus reflexes of the newborn
• 2: discus the Examination of the Newborn
• Marked in the next lesson

38. Physiology of the newborn/ neonate
• These are natural changes that occur when the baby has to adjust to
the extra uterine life
• Before birth
• In the uterus, the fetus lives in a sheltered life and gets the following
• Oxygen and nutrients are provided by the placenta
• Body temperature is regulated by liquor and the uterus
• Protection from micro-organisms by maternal antibodies and uterus
• Protection from injury by liquor amnil/ amniotic fluid

39. • At birth
• During labor fetus is subjected to diminution of oxygen supply due to
uterine contractions, compression followed by decompression of his
head & chest and extension of his limbs, hips and supine during
delivery.
• The baby emerges from his mother to encounter light noises cool our
gravity and lactic stimulus for the first time.

40. FETAL CIRCULATION

41. Changes of fetal circulation
• The major changes are as follows;
• 1. closure of the umbilical arteries: it occurs due to clamping and
cutting of the cord.
• 2. closure of umbilical vein: it occurs a little later than arteries,
allowing few extra vol of blood to be received by the fetus from
placenta
• 3. ductus venosus collapses and becomes ligamentum venosus
afterwards.

42. • 4. Foramen ovalecloses due to increased pressure of right artrium. It
happens due to expansion of lungs with enhancement of pulmonary
blood flow &loss of placenta circulation
• 5. the functional closre of ductus arteriosus may occur soon after
birth with the initiation of respiration&satisfactory pulmonary
circulation.
• NOTE: Read more on this.

43. • Individual Assignment 1.
• Read and make notes on the following
• Respiration system changes.
• Temperature regulation
• Digestive system
• Renal system
• Birth weight

44. References
• Pediatric nursing (as per INC syllabus) by parul Datta 4th edition

46. CARE OF THE NEWBORN